Professor Xu Jianmin Explains Treatment for Hepatometymety Patients With Non-Recital Colorectal Cancer (BECOME Study)

In 2013, Professor Xu Jianmin's team published the results of treatment for RAS wild-type CRC liver metastasis patients with citoxil monoantigen combined with mFOLFOX6 in Journal of Clinical Oncology, which has also changed the NCCN guidelinesPreviously, NCCN guidelines did not recommend treatment in patients with wild type RAS using citoxiaxil resistance combined with mFOLFOX6, while our clinical study found that combination therapy achieved better conversion excision rate, objective remission rate (ORR), no progression (DFS), total survival (OS)clinically, we found that 50% of patients with metastatic colorectal cancer (mCRC) were in the RAS mutationSo can these patients use existing weapons to achieve better treatment results during treatment?so we designed the BECOME study, which was used to add the treatment of mFOLFOX6 to patients with RAS mutant CRC liver metastasisTHE BECOME STUDY BEGAN IN 2013 AND ENDED IN 2017, WITH THE LAST FOLLOW-UP BEING IN JULY 2019THE BECOME STUDY INCLUDED 241 CASES OF RAS MUTATION INITIAL NON-REC LIVER METASTASIZED PATIENTS, DIVIDED INTO A COMBINATION TREATMENT GROUP (GROUP A) AND SIMPLE CHEMOTHERAPY GROUP (GROUP B) AT 1:1 RANDOMLY, GROUP A PATIENTS GIVEN MFOLFOX6 AND BEVABEZUMAB MONOANTIGEN, AND GROUP B PATIENTS GIVEN TREATMENT TO MFOLFOX6The main endpoints of the study were liver metastasis removal rates, and secondary endpoints were ORR, DFS, OS, and toxicityThe study designedthe liver metastasis rate in the combined bevala-zonal group was significantly higher than that of the pure chemotherapy group (22.3% vs5.8%, p 0.001), in addition, the objective mitigation rate of the chemotherapy-combined bevalbezumab group (54.5% vs36.7%, p 0.001), no progression survival (9.55.001) and total survival (25.7 months vs20.5 months, p.031) were significantly higherConversion resection ratePFS and OSBECOME study gives us an important lesson that for patients with RAS mutation, although the prognosis is poor, the use of our existing weapons can also improve liver metastasis removal rates, thereby significantly improving OS and PFSIn the future, we can explore more joint solutions to provide more evidence-based medical evidence for patients with RAS mutation symCRCTHE BECOME STUDY GIVES US AN IMPORTANT LESSON THAT THE TREATMENT OF RAS MUTANT CRC LIVER METASTIVAL METASTIVAL IS MORE POSITIVE, AND THAT THE TREATMENT OF COMBINED BEVALBEZUMAB BY CHEMOTHERAPY CAN ACHIEVE A HIGHER RATE OF LIVER METASTILATE REMOVAL AND SIGNIFICANTLY IMPROVE OS AND PFSSTHE BECOME STUDY IS THE FIRST AND ONLY CLINICAL STUDY TO DEMONSTRATE THAT BEVALZUMAB-COMBINATION CHEMOTHERAPY CAN SIGNIFICANTLY IMPROVE LIVER METASTASOTOMY RATES AND OSIt fills the gap in the RAS mutant population and further improves the evidence system of liver metastasis conversionAuthor: MedSci Source: MedSci OriginalHighlights review:135 ,on 2020-5-16 Comment:good(from:MedSci Medical)